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State-required forms do not accurately document eligibility and consent for organ donation

Many States require hospitals to complete a form for each patient who dies to report the patient's organ and tissue donation eligibility status—whether or not a request for an organ was made to the patient's family—and the outcome of the request. However, these State-required forms are not very accurate in documenting organ eligibility and procurement and thus may overestimate the organ donor pool, concludes a study supported in part by the Agency for Health Care Policy and Research (HS08209).

Designating and training responsible hospital staff on proper completion of the forms and designing forms that are easy to complete and as unambiguous as possible would improve organ donation reporting, recommend Laura A. Siminoff, Ph.D., of Case Western Reserve University, and Kristine A. Nelson, R.N., M.N., of LifeBanc. They conducted detailed chart reviews on a total of 2,270 patients who died during a 6-month period in 1997 at four trauma hospitals in Ohio. They also interviewed hospital health care providers and the staff members at organ procurement organizations and reviewed organ donation forms required by the Ohio Department of Health (ODH).

The ODH forms often contained missing, inaccurate, and contradictory data. For instance, the ODH forms reported almost four times more eligible organ donors than actually existed (151 patients vs. 39 patients identified by chart review). Also, ODH forms indicated that a request for organ donation was made in 136 cases compared with 25 requests identified through chart review and interviews with health care providers. The hospital ODH forms identified 21 families as consenting to organ donation compared with 14 families identified through manual chart review and health care provider interviews. The forms correctly identified 13 eligible families as giving consent but incorrectly identified one family as not giving consent when the family had consented. Accuracy in reporting organ donor eligibility status of patients ranged from 77 to 98 percent and in recording the consent decision from 50 to 75 percent in the study hospitals.

See "The accuracy of hospital reports of organ donation eligibility, requests, and consent: A cross-validation study," by Dr. Siminoff and Ms. Nelson, in the March 1999 Joint Commission Journal on Quality Improvement 25(3), pp. 129-135.